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Guidelines

The government is going to take control of healthcare to keep costs down

Some people will die sooner because treatment might be considered a waste of money

Women should wait an extra ten years before getting screened for the second-most deadly cancer they might ever face

Who planned the timing of this announcement regarding new mammogram guidelines? The U.S. Preventive Services Task Force could obviously use some help in their PR department!

It is with bemusement that I note all the hoopla surrounding the new mammogram guidelines.

None of my friends and acquaintances look forward to a mammogram. I certainly don’t! Nobody waits with eager anticipation until they are again eligible for their next squishing session. This is something that people postpone and do as infrequently as they can get away with. I don’t personally know anyone who is upset about the new recommendations. It’s more of a collective sigh of relief: Whew! Now we have a legitimate excuse to not go for that test!

When doctors claim, “studies show…” it insinuates that laymen are too stupid to understand the meaning of raw numbers. It harks back to the days of paternalistic medicine. I’d love to see the facts:

# of people in observation groups
# of people not getting mammograms
# of people getting mammograms – broken into two categories:
-routine screening
-in response to the discovery of a lump
# of those people who do self-exams
# of those people who do not do self-exams
# of people who found lumps doing self-exams
# of people who missed lumps in spite of doing self-exams…

# of patients whose mammograms led to biopsy
# of biopsies benign
# of biopsies malignant

# of people who had serious complications from benign biopsies (harmed due to mammogram)
# of people with malignant biopsies who were cured – break this out as to how many were discovered and treated due to routine screening vs how many of those biopsies were not because of a routine screening mammogram

Are we talking about one study or twenty? Is this data on thirty people, or five thousand? Show me that these studies were done on large groups of women in a variety of locals, and that the data is the same regardless of race.

An approach that presents the raw data can lead people to a logical conclusion. Instead of being paternalistic, this method clearly states the facts and implies that people are capable of making good decisions (this might not be true – people frequently make bad decisions, but PR is about perception).

It is so much easier to respond to anecdotes when the facts are readily available. Facts don’t belittle the heart-rending stories that are circulating; showing the raw data would acknowledge that some cancers are identified by routine screening. However, it would also make clear whether those anecdotes are typical, or if they’re anomalous. Make it clear – using incontrovertible numbers – whether more people are helped by routine screenings, or harmed.

(fwiw, this approach would be a good idea when presenting the facts about v.a.c.c.i.n.e.s, too)

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Happy Thanksgiving
So grateful to have gotten my flu shots
before getting together with family to share germs.
There are always people who show up sick because they wanted so much
not to miss out on the big get-together.
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